Cash Donation Information

To make a cash donation, print the form below,
complete it and mail or fax it.

Fax to:
Michelle Payne
Fax:  916-985-6884

Mail to:

A Hand UP Coaching
c/o donations
17817 W. 69th Terrace
Shawnee Mission, KS  66217



Name:____________________________________________________


Address:__________________________________________________


City:___________________________State:_______ZIP:__________


Phone:______________________________________________________


Method of payment: _____Check____Visa____Mastercard

Credit Card #___________________________Expiration Date:__________

Signature:________________________________________________



Amount of Donation: $_______

You will receive a receipt for your tax-deductible donation via mail within 2 weeks.

THANK YOU FOR YOUR SUPPORT